Provider Demographics
NPI:1033673595
Name:NATIONAL VISION INC
Entity Type:Organization
Organization Name:NATIONAL VISION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE SALES COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-448-2092
Mailing Address - Street 1:2435 COMMERCE AVE BLDG 2200
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-4980
Mailing Address - Country:US
Mailing Address - Phone:470-448-2092
Mailing Address - Fax:770-220-1969
Practice Address - Street 1:1930 DOUGLAS PKWY STE 54
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-7304
Practice Address - Country:US
Practice Address - Phone:814-844-6370
Practice Address - Fax:814-860-3428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty